Purpose: To investigate the clinical outcomes and imaging features of malignant peripheral nerve sheath tumors (MPNSTs) presenting as spinal dumbbell tumors.
Methods: We retrospectively reviewed the clinical outcomes and imaging features of consecutive cases of spinal dumbbell MPNSTs (n=8) and schwannomas (n=15).
Results: A maximal diameter>5 cm was more frequently seen in MPNSTs (88%) than in schwannomas (14%). Irregularly lobulated margins occurred frequently in MPNSTs (75%), but not in schwannomas (21%). Indistinguishable boundaries were observed in 63% of MPNSTs, but only 7% of schwannomas. Osteolytic bone destruction was found exclusively in MPNSTs (50% of MPNSTs vs. 0% of schwannomas).
Conclusions: There is little clinical information relating to spinal dumbbell MPNSTs. We propose that the following imaging features are suggestive of spinal dumbbell MPNSTs: maximal diameter>5 cm, irregularly lobulated shape, boundary indistinguishable from surrounding tissues, and osteolytic bone destruction.
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